Whose eyes are they, and whose blood is it?

 

There are some things about the healthcare industry in the UK that are Soviet in style; that may seem a strange suggestion, but the bureaucracy of the NHS bears more than a passing resemblance to that created by Lenin, Stalin and co up to the 1960s.. You can’t have what you want, be told something personal to you, or buy what you know you need, directly; you must go and see an often very well remunerated official to get a bit of paper to allow you to then buy whatever you know you want or need, or to find out something that is very specific to you, which in some ways might be no-one else’s damn business. 

We hear every day that the NHS is collapsing, even that we must shut ourselves away ‘to protect the NHS’.  Hospitals can’t admit any patients, and doctors can’t see anyone unless they first speak to them on the phone (that itself being an example of what I’m getting at); actually, it's all very 1970s Russia. If we needed a prescription from the GP to buy a loaf of bread (oh, dammit, I’m giving someone ideas now …) we’d all have starved by now.

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I’ve written before about the sometimes condescending and patronising attitudes that the healthcare industry shows towards patients. The issues I’m documenting here may arise because of just that sort of problem.

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A couple of months ago I needed some new glasses. It was not that my eyesight with my existing spec’s was unsatisfactory, no; I needed a new pair because the old ones were falling to bits. I am, I have to confess, not the most careful person when it comes to spectacles. Most of the time I wear contact lenses, but (as any contact lens wearer will tell you) I have to wear glasses sometimes - one day a week, a few hours every day, and, of course, in the middle of the night when I get up to go to the loo, or whatever I do in the dark hours. My spec’s are left on my bedside cabinet all night, and suffer all sorts of abuse when I wake, bleary eyed, realising a short walk is required: my right hand flails around feeling for them in the darkness, and on more than one occasion I have sent them flying across the bedroom, and they frequently end up down the back of said cabinet. They do even experience worse: I once broke a pair by misjudging - in broad daylight -  the closeness of the edge of a wardrobe; if the glasses hadn’t broken, my nose would have done. (Such misjudgements seem common in the minutes soon after replacing contact lenses with spec’s - peripheral view with the former is true, but with glasses there is noticeable refraction at the edge, especially if you’re quite short sighted - as I am.)

I buy contact lenses online; the company I use can deliver them the morning after I place my order, and the thing I like is that I can choose the prescription I want. I know my eyes, and that once you’re into your sixties you won’t get both perfect distance vision and perfect near or intermediate vision: that is, if your lenses let you read a car registration plate perfectly at forty yards (well over the legal requirement for driving) the chances are you will require a corrective lens to have good reading vision (ten inches from your eye) - or even computer screen vision (two feet or so). Hence for everyday use I go for lenses that give me less than perfect distance vision - just about good enough to drive,  but better vision at least for a computer screen, although I do keep some ‘special’ lenses for driving. My official prescription is -3.25 L, -4.75 R, but I usually wear -2.75 L, -4.00 R. It's perfectly legal for a business to sell you whatever contact lenses you want, it's your responsibility to ensure that you know what you’re putting into your eyes, and that your vision is sharp enough for whatever you need it to do - such as drive a car. 

This, however, does not apply to spectacles. When I wanted to purchase a new pair of distance vision spec’s online I had to provide a prescription, less than two years old., and I could only be supplied with a pair that matched that prescription. It didn’t matter that I knew what lenses I wanted in my glasses, I had to have an up to date prescription. To make matters worse, this was in late 2021, after we had all been scared away from our high streets for two years. My most recent prescription was dated 2019, and, of course, seemed to assume that I was only interested in reading the registration code of the aircraft that occasionally fly over at ten thousand feet on their way to Luton Airport. 

I arranged an eye test with a local optician. He desperately tried to convince me that what I required was a pair of varifocals - lenses that have different curvature going vertically down, so you have to tilt your head up and down to try to find the correct ‘setting’ for whatever you’re looking at - but I held out. Varifocals are ridiculously expensive, for carefully engineered lenses don’t come cheap, and I only need spec’s one day a week, and to watch TV in the evening, and to get to the loo in the middle of the night! He eventually gave me a prescription for my distance vision - exactly the same as my 2019 one - and agreed to order a pair half a dioptre stronger  in each lens (that is, -2.75 L, -4.25R). But I doubt I will be able to order such a pair online.

Why not? They are my eyes, and I know what I want to be able to see with them, and what strength lens will work for me! I spent half an hour in a farcical charade having my eyes tested, where I had to wear a mask, and the mask made the lenses of the test spec’s steam up, so I had to take a break every few minutes, or hold my breath, and I still didn’t end up with quite what I wanted - I prescription for the glasses I need.

Surely, in a ‘free’ country, shouldn’t we be able to buy whatever we want and hang it on our ears and nose? 

(There may be an argument that eye checks are a great way to see some aspects of general health - I agree - but I would argue that that does not mean you should have to be able to purchase only the spec’s that optometrists' rules decree you should?)

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A few days after my eye test I had to accompany Viv, my slightly disabled partner, to The Lister Hospital in Stevenage. She needed to have some blood tests, I can’t quite remember why; perhaps that’s another symptom of the problem I'm writing about, for patients are frequently required to attend an appointment without really being aware of the reason for it.

Viv used to be able to have such tests at our GP surgery, but they aren’t doing them any more, apparently because of Covid. We’ve been forced to accept this sort of ‘change’ in the way that ‘our NHS’ apparently helps us; I suppose we should be grateful, I dread to think where we’d have to go if it hadn’t been for all that banging of saucepans in 2020 - Inverness or somewhere I presume.

As her carer I keep records of Viv’s medical details - I’m more than aware of the inadequacies of data sharing between hospitals, and that any one clinic, doctor or A&E department will expect a patient (or their carer) to know everything about their medical history, most often using medical terminology. I had notes of her equivalent blood tests taken a year before, so, when she’d had the blood taken, I asked about how we might obtain the results.

‘You need to contact your GP’, the receptionist told me. 

‘Can’t I just get them directly, and contact the GP if we have any concerns please?’I queried, knowing how very difficult it is to contact our GP surgery, who must therefore be very busy, and we wouldn’t want to trouble them.

‘No, you must contact your GP to get your results’, came the answer. 

We resigned ourselves to an hour or two by the phone at some point in time a few days later, wondering who on earth might have dreamt up a set of processes as convoluted and bureaucratic as this. I toyed with the idea of making a Subject Access Request for the results under the Data Protection Act and GDPR. Exemptions to the right of access apply in a healthcare environment ‘if disclosure could cause serious harm to the physical or mental health of any individual’, (see https://ico.org.uk/for-organisations/guide-to-data-protection/guide-to-the-general-data-protection-regulation-gdpr/right-of-access/health-data/ ): I did wonder whether there might be a view among patronising NHS apparatchiks that it might cause serious harm for any of us, the hoi-polloi, to actually know the composition of our own blood, or whether the serious harm they could be worried about might be to them, if we were to find out how they were making us use up our time.  

‘But it’s my blood’, Viv complained, as we left the far-too-familiar hospital and wended our way homeward. We knew how it must have felt for the masses in Moscow, circa 1975.

I later raised the problem with our MP, pointing out that it would take next to no effort for the results of the tests to be printed and mailed to a patient (via a batch mailing facility), and that  would engage a patient in their own care; the next time they were asked to attend for a blood test they might realise why, or challenge the need if they felt it to be unnecessary. His understanding of the real word was revealed when he gave me his view on the ideal tool to deal with such health information: the NHS App. He’d clearly never been in an outpatient clinic waiting room and seen the people there, many of whom would struggle to use a smartphone. 

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I mentioned our local GP surgery, and that contacting it is very difficult. In fact, it is the subject of articles in our local paper, The Biggleswade Chronicle, almost every week.The April 22 edition included a story about a couple who had counted the number of times they had had to dial the number for the surgery before getting through: it was two hundred and eighty. Yes, two hundred and eighty. No, patients are not allowed to visit the surgery to arrange a doctor’s appointment, they must phone the relevant number, at the right time. On that 280th attempt the couple got to speak to a receptionist, who then arranged for a doctor to phone them - on a given day, but not at a specific time. Only after such a call might they then be invited to later attend the surgery so the doctor could actually see the problem. Isn’t this our equivalent of the day-long queues for bread that existed in Soviet Russia in the 70s - when one member of a family would queue all day for bread, and, after finally buying some, start queueing for the next day?

You might suggest that we should find another GP; I wish that were an option. There are only two practices in our town, and they are reported as having an ‘agreement’ between them that they will not accept transfers from the other. So very Soviet….

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The idea that all is well with the health service is, despite what our politicians and media would have us believe, not universally accepted. The Biggleswade Chronicle, my trusty source of information (at least for this story) reported on 8th April that 35% of staff at Bedford and Luton & Dunstable hospitals would not be happy with the standard of care offered there should a family member or friend require treatment. I’m not sure I’d like to eat at a restaurant if over a third of the staff there wouldn’t be happy with their friends or family eating at it.

Isn’t it time our politicians accepted that something needs to be done about the NHS?